SE Behavioural Risk Factors

Overview

• Course: Socioeconomic & Behavioural Risk Factors

• University: University of Glasgow

• Ranking: Top 100 University

• Title: Scottish University of the Year

Aims of the Study

• Understanding evidence investigating SED (socioeconomic determinants) to explain excess mortality (EM).

• Describing the influence of smoking and alcohol behaviours on health and mortality.

• Reflecting on the challenges of modifying behavioural risk factors.

• Acknowledging the Dahlgren & Whitehead Model, emphasizing a multidisciplinary approach:

  • Legislative

  • Intervention

  • Individual

  • Cultural

  • Environmental

Socioeconomic Status and Risk Factors

Carstairs Index

• Developed in 1981 using census data.

• Four Indicators:

  • Male unemployment

  • Lack of car ownership

  • Overcrowding in households

  • Low occupational social class (IV & V)

• Discussion of pros and cons of these criteria.

Carstairs Index Review

Pros

• Simple and straightforward.

Cons

• May not fairly reflect lack of car ownership.

• Excludes health measures critical for health data analysis.

• Only considers male unemployment as a criterion.

Indices of Multiple Deprivation

• Different home nations in the UK utilize various indices for socioeconomic deprivation (SED).

• Comparison between nations becomes challenging.

• Efforts have been made to correct or standardise these measures.

Scottish Index of Multiple Deprivation (SIMD)

• Factors Included:

  • Income

  • Employment

  • Education

  • Health

  • Access to services

  • Crime

  • Housing

• Current Data Zones (as of 2020) listed along with deciles.

• Most deprived and least deprived areas identified according to SIMD.

Research Findings: Ischaemic Heart Disease (IHD)

• Table analysis of IHD prevalence in Northern Ireland and France by socio-economic variables.

• Observations include marital status, total no. of people in household, accommodation ownership, and education level’s impact on IHD risk.

Mortality and Key Exposures

Socioeconomic Factors in UK

• Spatial divergence, political culture, and historical changes have influenced mortality outcomes.

• Higher mortality rates are reported in Glasgow, Liverpool, and Manchester.

• Understanding environmental and social disparities in health behaviour is crucial.

Smoking Trends and Impacts

Current Cigarette Smoking Prevalence

• Age-standardised data from 2003 to 2019 shows trends by area deprivation.

Alcohol Consumption Trends

Epidemiological Data

• Decline in UK alcohol consumption from 2000 to 2014.

• Comparison of Scottish alcohol consumption: 47% (men) and 23% (women) recorded hazardous levels in 2003, decreased to 31% (men) and 15% (women) in 2022.

Definitions, Measurements, and Guidelines

• Unit of alcohol defined;

• Recommended maximum being no more than 14 units per week, spread across multiple days.

• AUDIT helps assess problem drinking levels.

Alcohol-Related Disease and Mortality

• Overview of alcohol-related health outcomes including liver disease, etc.

• Significant surveillance of long-term trends in alcohol-specific death rates across regions.

Challenges and Solutions

• Identifying public health interventions and policies to combat smoking and alcohol-related behaviours.

• Multidisciplinary approaches needed in strategic health initiatives.

Final Thoughts

• Some excess mortality in Scotland is explainable through socioeconomic deprivation, a gap that is slowly decreasing.

• Smoking and alcohol-related health behaviours continue to challenge public health efforts, indicating the need for thorough intervention strategies.

Detailed Revision Notes: Socioeconomic & Behavioural Risk Factors

Intended Learning Outcomes

1. Understand evidence investigating SED to explain EM

   • Socioeconomic determinants (SED) are crucial in explaining excess mortality (EM).

   • The Carstairs Index is developed using census data assessing four key indicators: male unemployment, lack of car ownership, overcrowding, and low occupational social class (IV & V).

   • Indices of Multiple Deprivation (IMD) vary across UK home nations, complicating regional comparisons of SED and EM.

   • The Scottish Index of Multiple Deprivation (SIMD) identifies factors such as income, employment, education, health, access to services, crime, and housing.

2. Describe the influence of smoking & alcohol behaviours on mortality

   • Smoking trends have been analyzed from 2003 to 2019, highlighting prevalence in relation to area deprivation.

   • Alcohol consumption has decreased in the UK between 2000 and 2014, but hazardous levels remain concerning, especially among Scottish men (47% in 2003 down to 31% in 2022) and women (23% in 2003 down to 15% in 2022).

   • Key insights from epidemiological data relate smoking and alcohol consumption to significantly higher mortality rates, notably in regions like Glasgow, Liverpool, and Manchester.

3. Reflect upon the challenges of modifying behavioural risk factors

   • Modifying smoking and alcohol-related behaviours presents substantial public health challenges.

   • Various interventions are necessary, but require a careful consideration of individual, social, and environmental factors surrounding these behaviours.

4. Remembering the Dahlgren & Whitehead Model

   • The model highlights the importance of a multidisciplinary approach in health interventions:

     • Legislative: Policies that regulate harmful substances.

     • Intervention: Public health campaigns targeting smoking and alcohol consumption.

     • Individual: Understanding personal behavior and choices related to health.

     • Cultural: Addressing societal norms that influence smoking and drinking behaviours.

     • Environmental: Considering how the surrounding environment affects health choices and risks.

Conclusion

• There is a clear link between socioeconomic deprivation, smoking and alcohol behaviours, and excess mortality. Addressing these issues requires comprehensive, multidisciplinary strategies.